Should Calgary Fluoridation Proponents be asked to review the safety of water fluoridation?

A panel of Calgary fluoridation proponents are chosen to review new scientific evidence of fluoride's alleged safety and benefits

Health Action Network Society, Alberta Chapter

December 10, 1997

The Honorable Al Duerr, Mayor, and
Members of Calgary City Council

Dear Council Members

On September the 10th and 15th, a submission1 detailing the scientific data available on fluoride's increased health risks and lack of benefit since Calgary's last plebiscite in 1989 was presented to the Operations and Environment Committee (O&E). Attached to the Agenda was Calgary Regional Health Authority's (CRHA) "Position Statement on Fluoridation". Letters from scientists and professionals about CRHA's "misstatements", "glib comments proclaiming water fluoridation safe", and "head-in-the-sand position"2 accompanied our submission.2

On September 15th, O&E referred the information received to CRHA and the Administration for a review, provided that they consult with interested parties. Concerns were raised that CRHA was not the appropriate body to review the scientific information as they have a long history of promoting fluoridation. Addressing this point on behalf of CRHA, Ms. Jean Fraser (a Board member), commented that she "guaranteed" an objective review panel would be struck. A subsequent letter from Alderman Jones (former Chairman of O&E) indicated that the city would be appointing an impartial panel. Recent events show that both statements were overly optimistic.

On December 3rd, we tried to alert O&E to the biased composition of the city's recently appointed panel (attachment 1) and to new information which should have facilitated a discussion of the "need" to spend taxpayers' dollars reviewing information which had already undergone extensive review by a highly-credentialed panel of impartial professionals and scientists in Natick, Massachusetts (attachment 2).3 The Natick panel members were extensively grilled, not by city Administrators, but by city Councilors as to their qualifications and objectivity. The finalized report was presented to Natick Councilors on September 27, 1997. For whatever reason, the Chairman of O&E didn't give us or the Committee the opportunity to discuss it. I am now bringing this matter to your attention for consideration, preferably at the next O&E meeting or the next meeting of Council.

BACKGROUND: On October 29th, six weeks after O&E's resolution, Mr. Jack Locke and myself met with the City's Waterworks' Administration for the obligatory consultation. A summary of the meeting is as follows:

We were informed that the City, not CRHA, would be appointing the panel because the CRHA would be perceived as being too biased;

We were asked for feedback on the process and recommendations;

We were informed that the City's plan was to employ people who are qualified to evaluate the "pharmacokinetics" of fluoride and the epidemiology, something dental professionals are not trained for; therefore, dental representation on this panel would not be sought. A sensible and equitable approach to ensuring the review began on the right track;

That to ensure objectivity and neutrality, as prospective panel members were interviewed, the Administration would ask these professionals if they had any preconceived biases. In other words, were they in favor of or opposed to fluoridation;

We were promised a prior look at the prospective panel members and their Curriculum Vitas, so that any concerns could be expressed before the panel was finalized.

It was a productive meeting with much reason for optimism that the process would be one of the most pro-active steps the City has ever taken regarding this issue. That was then this is now: After various email and telephone communications, it was discovered that Mr. Seidner was no longer asking prospective panelists whether they believed in or were against fluoridation, BUT instead the question was "do you have a 'mission' where fluoridation is concerned?" In other words, it didn't matter if they were once active fluoridation promoters as long as they weren't doing it now! That's an inexcusable about-face, compared to earlier assurances of objectivity at the October 29th meeting. The question is why?

On Nov 13, 1997, 15:12:42, the list of potential panel prospects was emailed to me by Mr. Read Seidner, Laboratory Superintendent Calgary Waterworks, with the statement:"The final selection is yet to be made in consultation with CRHA." The prospective panel members were identified as:

Unlike the plan to consult with CRHA, we were not consulted as promised earlier but told; and then reluctantly! Again, the question is why? In stark contrast to the openness of Natick, MA Councilors, requests by our Society for prospective members' Curriculum Vitas were refused despite an earlier promise that they would be available. Why? Are they a national secret?

Later on Nov 13, I sent an email alerting the three Waterworks' representatives to the unacceptable bias of this panel. For obvious reasons, two panel members were not acceptable and should have been struck from the list:

In 1989, the "Together for Fluoridation Society", a front organization for Calgary Health Services (footnote), distributed a list to the media of individuals who "support" and "endorse" water fluoridation. Drs H. Moghadam, former member of the Calgary Board of Health, and D. Hanley were on this list. Dr. Moghadam's status on this list was also highly conspicuous.

The doctors' endorsement begs an answer to the following question: would anyone feel justice is served if juries were selected this way? Moreover, I also informed Administration that Dr. Hanley and I crossed paths in the Calgary Herald. I believe the titles speak to the content (articles available by request):

In light of this information, in my November 13th email, I requested that Administration reconsider one of the candidates whom I had proposed at our initial October meeting -- Dr. M. Richardson, an expert and unbiased environmental and human health risk assessor, previously employed by Health Canada and now with O'Connor and Associates. Because of a past assignment with HC, Dr. Richardson already has some working knowledge of the dental health of Canadians. He recently wrote a very technical Compendium, published and distributed by O'Connor and Associates, which summarizes all available Canadian data on body weight, food consumption, water intake, breathing rates, etc., It would surely be very useful for this review. My request for the reconsideration of Dr. M. Richardson was never addressed, and despite my objections to the two panel members mentioned, on November 27, 1997, 08:30, I was informed by email that panel members were unchanged and were officially selected.

Since Administration did not adequately address these and other concerns with respect to this review process, and because O&E also didn't address this issue or receive information on the Natick report which I tried to convey at the December 3rd O&E meeting, I am respectfully requesting that Council members give the following due consideration:

That the summary and conclusions of the Natick panel be given a full review by Council members and accepted as evidence, in addition to the letters and submissions to O&E in September, that there is now enough proof to either halt fluoridation immediately or to put the question to the electorate in 1998.

If Council, for whatever reason, wants to continue with its own review despite the recommendations by Natick scientists and professionals, that in order to restore a semblance of confidence in this process, Drs Moghadam and Hanley should be asked to resign from this Committee. If for whatever reason, this is not acceptable to Council, then we strongly recommend that Council take the appropriate steps to inquire whether Dr. Richardson is still available to complement this Committee. If so, special funding should be approved.

Thank you for your time and consideration. I look forward to your response.

Sincerely, Elke Babiuk

Director, HANS Alberta Chapter

Attachment 1 (moghad.doc): Letter to the editor, Calgary Herald, by Dr. Moghadam
Attachment 2 (natick.doc): Summary conclusions of Natick Review Panel, Full report or panel members' biographies available on request or at /natick.htm

Martin asks: "Where was all this contrary evidence when Calgary Health Services vigorously promoted fluoridation prior to the plebiscite?” The evidence was all there and was promoted just as vigorously by the opponents of fluoridation in all news media including the Herald. Calgary citizens voted in favor of fluoridation after weighing the evidence on both sides of the debate.

The basic tenet of anti-fluoridationists appears to be that for some cynical reason health professionals have conspired to harm the health of the public. Does Martin really believe... a host of scientific bodies have all ignored the so-called contrary evidence?” What would their purpose be for doing so?”

The fluoridation of communal waters and the resulting decrease in the prevalence of tooth decay in population has significantly affected the increase of dentists across North America; yet by far the vast majority of dentists support fluoridation. To say, as Martin does, that the scientific jury is still out is an insult to all scientific bodies that have been active in the struggle against disease...

It is a historical fact that nearly all public health measures have been opposed by some individuals. An outstanding example is the chlorination of communal waters. Yet we all know that were it not for this simple public health measure, many of us would not be here today to protest loudly that the scientific jury is still out or that our rights under the Charter have been violated. We would have succumbed to typhoid fever or cholera, a disease which currently is killing thousands of innocent people in South and Central America.

If common table salt were to be introduced to the market today there would be those who would oppose it since, like fluoride, it is also as Martin put it a "nasty stuff that burns human tissues” as it does our automobile bodies. And the scientific jury will stay out for decades debating its safety since, taken in large doses, it will kill every living thing.

H. Moghadam, MD

ADMINISTRATION'S RESPONSE

THE CITY OF CALGARYCOMMISSIONERS' OFFICE #8003
1997 December 19
His Worship Mayor Al Duerr and Members of Council

Ladies and Gentlemen:

SUBJECT: EXPERT PANEL ON FLUORIDATION

At the request of the Standing Policy Committee on Operations and Environment, a panel of scientific experts has been assembled to advise on recent scientific literature pertaining to the safety and effectiveness of water fluoridation. Panel members were selected in the following way. Because highly technical information needed evaluation, university researchers were seen as having the right mix of expertise and independence. Accordingly, Department Heads and Deans at The University of Calgary were approached to recommend potential panel members. Follow-up interviews with the prospective panel members were conducted by Waterworks staff to discern their commitment, and any possible predisposition to either the benefits or health risks of fluoridation. The objective was to gather an unbiased group with technical expertise that could focus on published research. It should be mentioned that previous support (or nonsupport) of the fluoridation issue involving the 1989 plebiscite in Calgary was not seen as a disqualifying factor
for a panel member because more recent information was to be the focus of the panel's attention. All prospective panel members were asked if they would review scientific evidence and make decisions objectively, and those that indicated a strong bias in favour of fluoridation were not asked to sit on the panel. Five panel members were chosen from various faculties (see attached Terms of Reference)

The selected five member panel met on December 3, 1997. At that meeting, Professor Dixon Thompson was chosen as chairman. The need to develop a sound communication plan was recognized and submissions received to date were distributed for review.

Newspaper ads inviting public submissions of technical reports had already been placed with a final deadline of December 12. At that meeting the panel members were again asked whether they were already biased in favour or against fluoridation. Two panel members, Professor Moghadam and Professor Hanley, indicated that as a result of research in the past that they had supported fluoridation but, if new research indicated that fluoridation was a health concern they were definitely open to changing their opinion.

TERMS OF REFERENCE: EXPERT PANEL FOR WATER FLUORIDATION REVIEW

BACKGROUND

At a recent meeting of the Standing Policy Committee on Operations and Environment some technical reports on water fluoridation were presented by private citizens. The Committee then resolved, along with Calgary Regional Health Authority, to have an independent and expert review of this and other recent information. The ultimate purpose of such a review is to advise whether water fluoridation is still a desirable public health policy in light of current data or risk/benefit studies. The Committee would then be assisted in its deliberation and subsequent reporting to Council over the advisability of a 1998 plebiscite on the continuation of fluoridation of Calgary's drinking water supply.

Waterworks Division is involved in the fluoridation issue only as a purveyor, giving sole attention to the proper operation, monitoring and compliance of the fluoridation process. Thus, it has been directed by the SPC on Operations and Environment to assume the role of coordinating and organizing an independent and unbiased panel of experts. Waterworks approached various Deans and Department Heads at the University of Calgary for recommendations. The expertise, maturity and independence of university researchers were considered important assets for prospective panel members. An adequate expertise profile to address technical issues of health and safety was sought. An effort was made to exclude mission oriented candidates (either strongly pro-fluoridation or strongly anti-fluoridation).

The panel will report jointly to the SPC on Operations and Environment-City of Calgary and to the Quality Care Committee-Calgary Regional Health Authority. Ongoing progress reports to Waterworks Division and Calgary Regional Health Authority is to be maintained by the panel chairman.

Work is to commence as soon as possible and completed by a presentation to the SPC on Operations and Environment Committee. Prior to that a written brief is to be submitted to Waterworks Division and Calgary Regional Health Authority. The panel chairman is responsible to verbally present the panel's findings to the SPC on Operations and Environment.

The focus of effort will be on literature produced since 1989. Literature additional to already received submissions will be sought through newspaper ads or may be provided by expert panel members. Verbal presentations at the panel's invitation only may be sought. If such are sought, then effort will be made to include equal opportunity from both sides.

Standard scientific criteria as to evaluating the pertinence of reports and studies will be employed. Methodology employed by the Canadian Task Force on the Periodic Health Examination will serve as a model. The panel will decide its own process of dividing up submitted literature.

All costs will be split equally by Calgary Regional Health Authority and Waterworks Division. Secretarial and library search assistance will be provided to the panel. The panel is to assess additional resources needed once all submissions are received.

DEADLINE DATES

December 12 Deadline for public submissions

March 23 Submit written brief to Waterworks and Calgary Regional Health Authority